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Charles W. Ruefenacht DDS NMD IBDM

Charles W. Ruefenacht DDS NMD IBDM. AAOT Dallas Texas April 11-13, 2013. Ozone for the treatment of root sensitivity. A. Symptoms B. Anatomical base C. Etiology D. Treatment protocol with ozone. Symptoms. Symptoms. Sharp, immediate, transitory pain to 1. cold 2. heat 3. air

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Charles W. Ruefenacht DDS NMD IBDM

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  1. Charles W. Ruefenacht DDS NMD IBDM AAOT Dallas Texas April 11-13, 2013

  2. Ozone for the treatment of root sensitivity A. Symptoms B. Anatomical base C. Etiology D. Treatment protocol with ozone

  3. Symptoms

  4. Symptoms Sharp, immediate, transitory pain to 1. cold 2. heat 3. air 4. biting*

  5. Anatomy and Etiology

  6. Enamel: • 98% inorganic • parallel enamel rods of HA • crystalline • brittle • not tough

  7. DEJ: interphase layer • 50:50 collagen/mineral (vol) • ~ 150 microns thick • binds brittle enamel w/ tough • dentin • shock absorber • allows for toughness • prevents crack propagation Physical properties of the dentin-enamel junction region. Urabe, Nakajima, Sano, Tagami. American Journal of Dentistry, Vol 13, No 3, June 2000, 129-135

  8. SEM etched dentin

  9. Dentin: • 50% mineral, 30% collagen • 25k/mm @ DEJ • 48k/mm @ pulpchamer • 2.8 micron diameter @ pulp • 0.8-1micron @ DEJ • peritubular dentin: more highly mineralized • odontoblast in each tubule SEM Dentin

  10. Martin Brannstrom: The Hydrodynamic Theory of Dential Pain: Sensation, Preparations, Cares and the Dentinal Crack. JOE 1986. Fluid movement through tubule stimulates the odontoblastic processes triggering pain fibers. 1. cold - outward 2. heat - compression 3. air - stretch, pain ends w/ desiccation.

  11. Ozone Treatment 1. identify the correct tooth 2. 10-15 gamma 3. high speed suction about 3/4 inch away from surface 4. apply ozone for about 10 seconds and re-test. 5. repeat ozone application until sensitivity gone. 6. collect money

  12. Treatment 1. turn off pain fibers with ozone 2. stop fluid flow with bondable resins and probably with ‘plugs’ due to remineralization.

  13. Now you know more than most dentists.

  14. Thanks!

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